Work plan for the Reexamination of Discharged Covid-19 Patients （Provisional）

Promulgation Date: 2020-4-6
Title: 国务院应对新型冠状病毒感染肺炎疫情联防联控机制关于印发新冠肺炎出院患者复诊复检工作方案（试行）的通知
Document Number:国办发明电〔2020〕15号
Expiration date: 
Promulgating Entities:State Council Joint Mechanism for the Prevention and Control of the Covid-19 Epidemic

Source of text: http://www.gov.cn/zhengce/content/2020-04/08/content_5500372.htm

This plan is specially formulated to further complete work such as isolated observation, reexamination, health monitoring, and rehabilitation management for Covid-19 patients after they are cured and discharged from hospital, making it so that the entire process is managed and promoting the comprehensive rehabilitation of patients.

I. Duties and Division of Labor

(1) All levels of health department should strengthen overall planning and coordination for isolated observation of discharged Covid-19 patients, guiding designated hospitals, isolation areas, rehabilitation institutions, and basic- level medical establishments to closely cooperate, strengthen communication, and coordinate to complete work such as for post-discharge isolated observation, reexamination, health monitoring, and rehabilitation management.

(2) Designated hospitals should do a good job of follow-up visits, regular periodic reexamination, and health guidance for discharged patients. Basic-level medical establishments should do a job of efforts such as in-home isolated health monitoring and health management. Centralized isolation points should do a good job of health monitoring and daily care work.

II. Management of Isolation

(3) After Covid-19 patients are treated and discharged, they shall continue isolated medical observation for 14 days. During the isolation period, body temperature, physical indicators, and other physical conditions are to be monitored daily to observe whether there is fever, cough, asthma, or other respiratory symptoms. After patients are discharged, in-home isolation or isolation in a centralized isolation point may be employed. All levels of health department should guide medical establishments in managing the isolation and monitoring the health of discharged patients and their families. Designated hospitals should promptly send information on discharged patients to the residents (village) committee and basic level medical establishments for the patients' place of household registration or residence. In regions that have set up centralized isolation points, the health departments should guide designated hospitals and centralized isolation points to connect and to complete work such as isolated observation of patients, basic rehabilitation, psychological intervention, and health monitoring.

(4) Discharged patients going into in-home isolation shall change their clothing, wear masks with family members, avoid using public transportation, and thoroughly clean and disinfect their hospital clothes after getting home. To the extent as possible, stay in a single-person room with good circulation during the isolation period, and with the guidance of the basic-level medical establishments, carry out monitoring of one's own health, wear masks, and frequently open the windows of the isolation room to maintain air circulation, but also keeping warm at the same time. The number of caretakers should be reduced as much as possible, have separate meals, avoid close contact with family members, do a good job of hand sanitation and routine cleaning, and avoid going out for activities. Items for routine daily use during the isolation period shall be independently cleaned and disinfected.

(5) Rooms in centralized isolation points shall have good independent circulation and have independent restrooms, and those in isolation must not in principle have activities outside their room. Appropriate emergency supplies, medical personnel, and other staff should be allocated to ensure the lives and safety of discharged patients.

III. Management of Re-examination

(6) Designated hospitals should strictly enforce the discharge standards in the Covid-19 Diagnosis and Treatment Plan and carry out the post-discharge matters for attention. Before patients are discharged, experts should be organized to make a comprehensive assessment combining clinical symptoms and indications with the results of laboratory and imaging examination, so as to clarify the matters to be followed-up on. Establish a special follow-up registration system and manual, sign a discharge notice with patients, and give detailed notice of matters needing attention after discharge.

(7) Designated hospitals should arrange a 2-4 week reexamination plan for discharged patients, emphasizing routine blood work, biochemistry and oxygen saturation, repeating etiological detection tests for Covid-19 and giving priority to sputum samples which have a higher degree of reliability. Conduct chest CT imaging inspections of pneumonia patients.

(8) Conduct respiratory function tests for serious and critical patients who are discharged. Conduct guidance on rehabilitation based on discharged patients pulmonary absorption, pulmonary fibrosis and pulmonary function damage, limb function, psychological function, making rehabilitation assessments and draw up focused rehabilitation treatment plans in accordance with the requirements of the "Health Management Plan for Discharged Covid-19 Patients (Provisional)" to provide rehabilitative training and psychological interventions.

IX. Discharged patients should follow the reexamination plan to be reexamined at designated hospitals. The relevant medical establishments and centralized isolation points should pay close attention to patients' health, and especially strengthen health monitoring for discharged patients who are elderly or have existing conditions. Patients discharged from designated hospitals at the provincial-level or districted-city level, should in principle be reexamined at designated hospitals in their area.

IV. Management of Persons with Positive Nucleic Acid Testing Results

(10) Discharged patients that test positive on nucleic acid test reexamination who also have a fever, cough, or other clinical presentations, or CT imaging shows a conspicuous worsening of pneumonia, they are confirmed cases and shall be brought to designated hospitals for further treatment as soon as possible. Where nucleic acid testing is positive, but there are no clinical presentations or imaging manifestations, they are confirmed cases in the rehabilitation period and shall continue isolated observation and follow this Plan to do a good job of personal protection and related work. All levels of health department shall do a good job of publicity on popular science, periodically publishing relevant information to the public, to create a positive and active social environment and eliminate discrimination against patients.